Provider Demographics
NPI:1952435919
Name:THIAGARAJAH, CHRISTOPHER K (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:K
Last Name:THIAGARAJAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12466
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-0466
Mailing Address - Country:US
Mailing Address - Phone:202-550-1190
Mailing Address - Fax:
Practice Address - Street 1:1140 EDWARDS VILLAGE BLVD UNIT B206
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:CO
Practice Address - Zip Code:81632-5562
Practice Address - Country:US
Practice Address - Phone:720-509-9889
Practice Address - Fax:720-528-7671
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0046166207W00000X, 207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000511204OtherFACET
OH2756012Medicaid
IN200854040Medicaid
CO98806033Medicaid
OH4206041Medicare PIN
OH4206042Medicare PIN
I72153Medicare UPIN
CO98806033Medicaid
OH4206044Medicare PIN